Individual
TODD GORDON NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
521 ADAMS AVE, MORTON, WA 98356-9323
(360) 496-5112
(360) 496-3508
Mailing address
PO BOX 4008, PORTLAND, OR 97208-4008
(503) 372-2740
(503) 372-2754
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
098006952RN
OR
163W00000X
Registered Nurse
RN00073075
WA
367500000X
Certified Registered Nurse Anesthetist
098006952CRNA
OR
367500000X
Certified Registered Nurse Anesthetist
Primary
AP60786034
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2105898
—
OR
Enumeration date
06/27/2006
Last updated
11/10/2023
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